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Urgent Care Guide > Skin 1 > Flashcards

Skin 1 Flashcards

1
Q

viral exanthem

A

rash accompanying a viral syndrome

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2
Q

viral exanthem - most commonly looks like

A

erythematous, maculopapular rash, bilateral and symmetric, through can vary

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3
Q

viral exanthem - may occur when during viral illness

A

at any point

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4
Q

viral exanthem - may have associated what

A

systemic symptoms - fever, malaise, URI symptoms

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5
Q

viral exanthem - pruritic or no?

A

could be

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6
Q

viral exanthem - roseola findings
3

A
  1. early childhood febrile illness
  2. fever w/ rapid defervescence followed by rash
  3. erythematous macular or maculopapular rash
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7
Q

viral exanthem - measles findings
3

A
  1. 3 C’s - cough, coryza, conjunctivitis
  2. morbilliform (flat or raised red or pink bumps that may form together) eruption starting on the head - behind ears and forehead and progressing caudally (down)
  3. Koplik’s spots - white/gray papules on buccal mucosa which are pathognomonic
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8
Q

viral exanthem - rubella findings
1

A

rose pink coalescing (merging) macular lesions

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9
Q

viral exanthem - parvovirus B19/5th disease findings
1

A

erythematous “slapped cheeks”, then reticulate (net lick) extremity eruption

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10
Q

viral exanthem - coxsackie virus aka

A

hand foot and mouth dx

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11
Q

viral exanthem - coxsackie virus/HFM findings
1

A

vesicular lesions on palms, soles, and oral surfaces

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12
Q

viral exanthem - varicella zoster/chickenpox
3

A
  1. vesicular rah on an erythematous base
  2. lesions ranging from macules to papules to vesicles to crusts
  3. trunk > extremities
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13
Q

viral exanthem - herpes zoster/shingles
1

A

reactivation of varicella - vesicular rash in dermatomal distribution

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14
Q

viral exanthem - molluscum contagiosum findings
1

A

umbilicated and flesh colored nodular lesions

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15
Q

viral exanthem - epstein barr virus EBV findings
2

A
  1. difficult to differentiate from strep pharyngitis - fever, tonsillitis, lymphadenopathy
  2. confluent maculopapular rash may occur following tx of tonsillitis w/ amoxicillin/ampicillin for suspected strep pharyngitis
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16
Q

viral exanthem - HSV findings
1

A

vesicular lesions to oral, labial, and/or genital surfaces

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17
Q

viral exanthem - HPV finding
1

A

warts

18
Q

viral exanthem - img/testing

A

none usually; dx largely clinical

19
Q

at what age can child start to use hydrocortisone cream and why

A

2 years or old - it can delay growth and cause skin damage to those younger than 2.

20
Q

viral exanthem - tx options
3

A

supportive, consider -
1. antihistamines
2. bland emollients/calamine lotion
3. topical vs systemic analgesics

21
Q

viral exanthem - steroids?

A

do not shorten coarse, and not rec in children younger than 2

22
Q

viral exanthem - when do you consider antiviral tx (for suspected what case)

A

for suspected HSV - acyclovir, valacyclovir

23
Q

viral exanthem - emergent referral to optham. for what

A

suspected herpes ophthalmicus - Hutchinson’s sign (lesions to tip of nose) strong predictor of ocular involvement

24
Q

viral exanthem - when to refer to OBGYN

A

if rubella suspected in pregnant pt - can have fetal consequences

25
Q

viral exanthem - when to refer to ER
5

A
  1. severe systemic sx
  2. immunocompromised pts w/ severe sx
  3. neonatal herpes
  4. petechial/purpuric exanthem - meningitis, acquired thrombocytopenia
  5. suspected herpes ophthalmicus
26
Q

contact dermatitis

A

inflammatory skin condition involving an erythematous, pruritic eruption following contact with an allergen or irritant

27
Q

contact dermatitis - if unknown exposure, inquire about
3

A
  1. new soaps, lotions, detergents, topical meds, clothing or linens not pre washed
  2. occupational exposure such as chemicals or latex
  3. exposure to wooded areas or recent gardening
28
Q

acute contact dermatitis - PE findings
5

A
  1. erythematous
  2. macules
  3. papules
  4. vesicles
  5. ulcerative lesions
29
Q

chronic contact dermatitis - PE findings
3

A
  1. erythematous
  2. dry
  3. fissuring
30
Q

contact dermatitis - eruption is common where and why

A

hands d/t repetitive chemical or occupational exposure

31
Q

contact dermatitis - img/testing

A

none usually

32
Q

contact dermatitis - tx options in general
6

A
  1. avoid the exposure
  2. lotions
  3. steroid ointment
  4. systemic steroids
  5. antihistamines
  6. topical or systemic abx
33
Q

contact dermatitis - tx lotion example

A

calamine lotion

34
Q

contact dermatitis - steroid ointment overview
3

A
  1. consider mid to high potency topical steroid ointments such as triamcinolone 0.1% or clobestasol 0.05% (2-3 x day prn)
  2. avoid high potency steroids on face or genitalia or in children
  3. consider low potency steroid for children such as hydrocortisone or desonide ointment
35
Q

contact dermatitis - best steroids for children
2

A
  1. hydrocortisone
  2. desonide
36
Q

contact dermatitis - desonide age

A

3 months or older

37
Q

contact dermatitis - desonide, pediatric instructions

A

for 3 months or older, BID foam or gel

38
Q

contact dermatitis - systemic steroids, consider if
2

A

rash involves >20% of surface area or significant involvement of face or genitalia

39
Q

contact dermatitis - systemic steroid rx PO

A

prednisone 0.5-1 mg/kg for 5-7 days, with 1-2 week taper after

40
Q

dermatitis personal review - IM injection

A

Kenalog IM injection, triamcinolone may be effective for dermatological conditions (Kenalog -40mg is standard and usually effective )

41
Q

contact dermatitis - antihistamines

A

diphenhydramine or hydroxyzine - often not effective in pruritis but may offer some relief and sleep aid if needed

42
Q

contact dermatitis - when to refer to ER

A

signs of systemic infection - fever, tachycardia, hypotension

Urgent Care Guide (38 decks)

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